Hydrocortisone tertiary-butylacetate for intra-articular therapy in rheumatic diseases.

In arthritic individuals who have only one or two peripheral joints causing difficulty, it would seem advisable to treat these joints locally by direct intraarticular injection of medication in an effort to decrease the incidence and severity of toxicity associated with systemic therapy. The first very effective anti-rheumatic preparation for intraarticular injection was hydrocortisone acetate (hereafter referred to as hydrocortisone). Hollander, Brown, Jessar, and Brown (1951), Stevenson, Zuckner, and Freyberg (1952), and Kersley and Desmarais (1952) demonstrated a beneficial response in approximately 70 to 80 per cent. of joints so treated with an average duration of improvement 2 to 3 weeks. Recently, Hollander, Brown, Jessar, Udell, Smukler, and Bowie (1955) reported superior results with a derivative of hydrocortisone, hydrocortisone tertiary-butylacetate* (hereafter referred to as TBA). The purpose of this article is to report our experiences with the intraarticular administration of TBA in 38 patients, eighteen with rheumatoid arthritis, and twenty with osteo-arthritis.